Immune D/O... Flashcards
Innate versus acquired immunity
Innate immunity = rapid response, consists of the physical, chemical, molecular,& cellular defenses that are in place before infection & can fx. immed. as an effective barrier to microbes. (skin, gastric juice, lymph system, specific markers on our blood cells & all other cells/antigens represent such an innate immunity)
Acquired immunity = developed after birth as a result of a disease or vaccination/ immunization.
specific versus non-specific immunity
Specific Immunity = recognition & differentiation of “self” versus “non-self” based on specific cellular markers. (Lymphocytes are very specific - lock & key)
Non-specific Immunity: Does not require specific markers for actions (neutrophils, eosinophils, basophils, monocytes & macrophages)
humoral versus cellular immunity & the cells of the immune system, which are considered major in each part?
Humoral Immunity: Liquid form of immune defense, represented by B-lymphocytes & their manufactured anti-bodies (immuno-globulins).
Cellular Immunity: Represented by T-lymphocytes - develop in peripheral blood & more mature (T is for Thymus)
passive vs. active immunity & the ways of their acquisition.
Passive Immunity: pre-formed defense “tools” & administered to a human as anti-bodies, produced in another biological organism or human organism. (ex., momma giving $ to baby; passiveley acquired can be done as an adult as well - tetnas bacteria - insert imunoglobulins & will fight faster than eg 2-3 weeks; temporary)
Active Immunity: produced by the body’s immune system itself, as a response to infection or vaccination. (Actively is when killer cells - ur immune system is producing on its own - immune system worked for it or …Vaccinate can be actively considered as well)
Organization of the immune system: what organs, tissues & cells involved? What is the major role of lymph nodes? Spleen? etc
Tonsils & Adenoids =
Thymus =
Lymph nodes = contain spec. compartments where immune cells congregate, & encounter antigens
Spleen = communicate info about intruders/activate
Appendix =
Peyers Patches =
Lymphatic Vessels = connect immune sys organs
Bone Marrow = stem cells store immune cells
What immune cells (white blood cells) are considered non-specific? Specific?
non-specific = neutrophils, eosinophils, basophils,monocytes & macrophages…NK cells
specific = lymphocytes, Lymphoid precursors develop into the lymphocytes. 2 major classes of lymphocytes are B cells & T cells. The lymphocytes with the exception of so called Natural Killer cells, are specific immune cells. They need a very particular recognition of an antigen or an epitope.
What is the principal difference between participation of B-lymphocytes versus T-lymphocytes in the immune defense? What are sub-populations of B- & T-lymphocytes & what is their corresponding role in mounting of the immune response? In other words, what are plasma cells & their action, T CD-4 cells & their types/ actions; T CD-8 cells & their types/ actions?
B Lymphocytes = humoral immunity —subpop. of antibodies/immunoglobulins - aka “fork”; plasma cells produce specific antibodies
T Lymphocytes = cell mediated immunity & antibody production —subpop. of 1. TCD4 (Helper cells - activate many immune cells incuding B & T), 2. TCD8 (Cytotoxic cells - help rid the body of cells that have been infected by viruses as well as cells that have been transformed by cancer. They are also responsible for the rejection of tissue & organ grafts) & 3. TCD8 Suppressors subset of regulatory T cells - act to turn off or suppress immune cells.
Do Natural Killer cells belong to specific or non-specific part of the immune system?
NK’s are non-specific; considered innate immunity. They kill intracellular microbes & foreign agents.
Major classes of the immuno-globulins and their corresponding actions: IgM, IgG, IgA, IgE. Basic unit of an antibody (immune-globulin).
Basic unit of an antibody (immune-globulin) is a B plasma cell.
IgM = combines in star-shaped clusters. It tends to remain in the bloodstream for some time after initial infection, where it is very effective in killing bacteria.
IgG (4 types) = titer is signif amount of IgM G; 80 percent of serum is IgM G; very tiny - monomers - can be transitted vertically - mom to baby - passively acquired - they are momory immunoglobulins
IgA (2 types) = a doublet—present in body fluids such as tears, saliva, & the secretions of the respiratory, genito-urinary, & gastrointestinal tracts (all mucosa)
IgE = normally present in only trace amounts, but it is responsible for the symptoms of allergy. It is usually attached to Basophils, eosinophils or mast cells. Eeeee!
Allergy as Type I Immediate Hypersensitivity reaction. What class of immune-globulins involved & what is their exact mechanism of triggering an allergic response?
IgE; individual’s B cells make large amounts of grass pollen IgE antibody, attach to granule containing cells known as mast cells, which are plentiful in the lungs, skin, tongue, & linings of the nose & GI tract, next time that person encounters grass pollen, the IgE-primed mast cell releases powerful chemicals that cause the wheezing, sneezing, & other symptoms of allergy
Type II or Cytotoxic Hypersensitivity reaction: Types of blood w/in the group ABO & possible hemo-transfusion (incompatibility) reactions?
Cytotoxic —
Types of blood/agglutinogens: A, B, AB (Universal recipient) & O (Universal Donor)
Reactions: blood clotting, Rh Positive baby
Type II or Cytotoxic Hypersensitivity reaction: Within the pair of a donor- recipient, whose erythrocytes will undergo hemolysis in case of incompatibility?
IgM, IgG antibodies against cell surface or extracellular matrix.
Caused by: antibody-mediated cell destruction include mismatched blood transfusion reactions, hemolytic disease of the newborn due to ABO or Rh incompatibility.
In what organism will the cytotoxic action of auto-antibodies against foreign antigens of erythrocytes trigger anaphylactic reaction?
Anaphylaxis is a systemic life-threatening hypersensitivity reaction characterized by widespread edema, vascular shock secondary to vasodilation, & difficulty breathing.
W/i minutes after exposure to allergen (bee sting, sting, peanut etc), itching, hives, & skin erythema develop, followed shortly by bronchospasm& respiratory distress. Vomiting, abdominal cramps, diarrhea, & laryngeal edema & obstruction follow, & the person may go into shock & die w/in the hour.
What types of blood within the ABO group, are considered a “Universal Donor” versus “Universal Recipient” respectively?
Universal Donor = O type Universal Recipient = A/B Type
Innate Vs. Adaptive Table
______ immune system consists of lymphocytes & their products, including antibodies. Whereas the cells of the innate immune system recognize structures shared by classes of microorganisms, the cells of the adaptive immune system (i.e., lymphocyts) are capable of recognizing a vast array of substances produced by microorganisms as well as noninfectious substances & developing a specific immune response that differs with each substance.
Adaptive Immune system (Substances that elicit adaptive immune responses are called antigens. A memory of the substance is also developed so that a repeat exposure to the same microbe or agent produces a quicker and more vigorous response)
Proper _______ of the immune defenses are infectious organisms—bacteria such as 1. streptococci; 2. Fungi, 3. Parasites, & 4. Viruses
targets
Foreign molecules carry distinctive cluster of molecules, called “antigens” or their protruding from the surface parts, “_______”.
epitopes (in red)
What are 4 types of Immunization?
- ____ can be used from former toxin - actively acquired
- _______/_______ - passively acquired
- vaccines - ______ acquired
- disease - _______ acquired
Immunization:
* toxoids can be used from former toxin - actively acquired
* Immunoglobulins/ antio-bodies - passively acquired
* vaccines - actively acquired
* disease - actively acquired
Any non-self substance capable of triggering an immune response is known as an ______
antigen
There are some chemical substances of non-microbial origin that could trigger an immune response as_____
allergens
macrophages help to scavenger & ______ help them to internalize them
immunoglobulins
mast cells, granulocytes,… are ______ cells of immune system - scavengers - macrophages are supervisors…
nonspecific (specific cells are lymphocytes only)
commandoes”) of the immune system?
lymphocytes/WBC’s that are key operatives
(“commandoes”)
mostly known as cytokines - they exchange in liver, kidey, spleen & lymphnodes - communicate info about intruders - they activate
Organs of immune system photo
Cells classified as granulocytes are ____, ____ ,_____
neutrophils, eosinophils, and basophils
Cells classified as agranulocytes are ____, ____, ____
Lymphocytes, monocytes, & macrophages
The ___ lymphocytes, is essential for humoral immunity. The other class of lymphocyte, the ___ lymphocytes, is responsible for cell mediated immunity, as well as aiding in antibody production.
The various types of lymphocytes are distinguished by their fx. & response to antigen, cell membrane molecules & receptors, types of secreted proteins, & tissue location.
B Lymphocytes = humoral immunity
T Lymphocytes = cell mediated immunity & antibody production
T/F: The innate immune sys. is able to distinguish between self & nonself, but is unable to distinguish between agents
True
Auto-antibodies, produced by B lymphocytes of “self” or T CD8 killers of “self” travel by blood & attack antigens (clusters of molecules) on membranes of organ- & tissue cells aka _______
Type II Hypersensitivity or Cytotoxic Immune Reaction
Blood Type Chart
Type ___ Hypersensitivy responses are mediated by the IgE-class immunoglobulins & include anaphylactic shock, hay fever, & bronchial asthma
Type I
Type ____ Hypersensitivity responses, involve an antibody-mediated cell destruction (e.g., transfusion reactions & hemolytic anemia), complement - & antibody-mediated inflammation (e.g., some forms of glomerulonephritis), & antibody-mediated cell dysfunction (e.g., Graves disease and myasthenia gravis)
Type II
Type ____ hypersensitivity reactions, which involve the formation and deposition of insoluble antigen–antibody complexes, and are responsible for the vasculitis (seen in SLE or acute glomerulonephritis), systemic immune complex disease (serum sickness), & local immune complex disease (Arthus reaction)
Type III
Type ____ cell-mediated hypersensitivity reactions, which include direct cell cytotoxicity, in which sensitized CD8+ T cells kill antigen-bearing target cells; & delayed-type hypersensitivity reactions, in which presensitized CD4+ T cells release cytokines that damage and kill antigencontaining cells.
Type IV
These are all S&S of ________ _______
MORNING STIFFNESS greater than 1 HOUR
SOFT TISSUE SWELLING IN A HAND JOINT
SOFT TISSUE SWELLING in 3 out of 14 joint GROUPS
PIP’S, MCP’S, WRISTS, ELBOWS, KNEES, ANKLES, MTP’s
SYMMETRICAL SWELLING IN MORE THAN 1 JOINT AREA
RHEUMATOID NODULE
RHEUMATOID FACTOR
RADIOGRAPHIC CHANGES IN THE WRIST OR HANDS. (POROSIS /EROSION)
Rheumatoid Arthritis
These are all S&S of a Type _____ Hypersensitivity reactions: Immune Complex Deposition Disease. Possible causes. Serum Sickness 14+ days later as a result of exposure to antibodies derived from animals or Immune complexes aka clusters of interlocking antigens & antibodies that continue to circulate, & eventually they become trapped in & damage the tissues of the kidneys, or in the lungs, skin, joints, or blood vessels.
Type III (the most common causes of this allergic disorder include antibiotics (especially penicillin) and other drugs, various foods, and insect venoms.
Rheumatoid arthritis: nature of the disease, possible risk factors, pathogenesis, clinical manifestations, complications, major diagnostic criteria. What is an RF (Rheumatoid Factor)?
Immune Hypersensitivity reaction D/O (Type 3) - Inflammation of sonovial joints, T-cell malfunx - connective tissues being injured by self-IgG. CHRONIC RELAPSING DISEASE characterized by GENERAL ILL HEALTH, CHRONIC SYNOVIAL INFLAMMATION OF JOINTS & TENDONS in symmetric distribution, & SYSTEMIC S&S. There is a definite familial tendency & also environmental factors to it’s etiology. More common in females with a 3:1 ratio for women btwn 35-55 yrs of age. Ulnar deviation of joints in hands, affects joints symmetrically, attacks wrists, hands, elbows, shoulders knees & ankles. Affects individuals with specific type of cell markers or MHC antigens on their cell membranes: DR-1, & DR-4.
SLE (Systemic Lupus Erythematosus): same as per Rheumatoid Arthritis. What antibodies are produced by the immune system of “self” in SLE? What are the triggering factors? What is the clinical hallmark of the disease?
A multi-system connective tissue disorder including skin, joints, blood, kidney, lung, brain, & other organs. Gentetic, Hormonal or environmental influences can trigger. ANA’s - anti-nuclear antibodies are produced in SLE, “Friendly Fire cells”. Much more common in females, 9:1 ratio and higher in Af-Am and Asian pop. Evidence suggests that estrogens stimulate and androgens suppress the immune response. B & T-Lymphocytes become over-reactive. Arthralgia, Arthritis, Joint Deformity similar to RH-A, Tenosynovitis & butterfly rash Avascular Necrosis are clinical presentations.
Graves’ Disease: what is the character & type of the anti-bodies generated by the immune system, which excessively stimulate the thyroid gland? What are the clinical presentations of Graves’ disease, based on your body of knowledge of the physiology of thyroid gland and its hormonal secretions?
An auto-immune D/O of B-Cells - TSH receptor anti-bodies stimulating thyroxine production leading to hyperthyroidism, Type II Antibody-Mediated Cellular Dysfunction. Most common in women over 20. Causes Overactivity of thyroid gland aka Hyperthyroidism causes bulging (eyes - Exopthalmos) also, heat intolerance, increased energy, difficulty sleeping, diarrhea, and anxiety.
.
Myasthenia gravis: what self-immunoglobulins (auto-antibodies) produced by the immune system of affected patients and what is the mechanism of their action? Clinical presentations.
D/O in which normal communication between the nerve & muscle is interrupted at the neuromuscular jx. Receptors for acetylcholine at the muscle surface are destroyed or modulated by antibodies that prevent the normal reaction from occurring. The Disease affects 3 of every 10,000.00 people, primarily young female & older males. Clinical presentations = muscle weakness, vision problems, esp eye-drooping.
Ankylosing Spondylitis may have symptoms that affect other parts of the body besides the ____ & ______, including the heart and blood vessels. This condition tends to be inherited, and generally occurs in men between the ages of 16 & 30. The majority of people with ankylosing spondylitis have a gene called _____
joints & linaments (Bamboo Spine); HLA-B27
Type IV (Delayed) Hypersensitivity reaction, mediated by T lymphocytes: clinical significance of PPD test.
Not caused by anti-bodies like other three types, but by immuno-competent cells (T-lymphocytes). They occur 12 - 48 hours after exposure to the antigen. They lead to inflammatory tissue damage and infiltration of cells, which are principally lymphocytes and macrophages. Classical examples of type IV hypersensitivity are the positive tuberculin reaction, contact dermatitis (e.g. caused by nickel or chrome), and rejection of tissues, transplanted from other individuals. PPD is a test used to determine if someone has developed an immune response to the bacterium that causes tuberculosis (TB)
CREST is an acronym for the clinical features that are seen in a patient with this disease…
Scleroderma (Systemic Sclerosis)
CREST = Calcinosis - calcium deposits in skin, Raynaud’s** phenomenon - spasm of blood, **Esophageal** dysfx - acid reflux & decreased esophageal motility, **Sclerodactyly** - thickening/ tightening of skin on fingers/hands, **Telangiectasias - dilation of capillaries/red marks on skin surface
